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Urine Elements US FedEx Shipping Instructions: 1) Place the cardboard kit box containing the specimen and the completed test requisition form into the FedEx Clinical Pak. 2) Write your name and address in the space provided on the prepaid Billable Stamp and tear off the Customer Receipt for your records. Affix the Billable Stamp to the Clinical Pack in the space provided. 3) Call FedEx toll free at 1-800-238-5355 to schedule your pickup. When you hear the automated greeting say “REP”. You will then be asked if you are calling to ship a package; reply "YES" to be connected directly to a live FedEx representative. Tell the representative that you need a pickup for a shipment using a prepaid “BILLABLE STAMP” and give your address. Do not use a drop box. FedEx will not accept specimens placed into a drop box. Doctor’s Data provides prepaid shipping materials for use in shipping specimens from Canada, Ireland, United Kingdom, and the United States. If you are located outside of these countries or choose to use a different courier or level of service than provided, you must make your own shipping arrangements at your own expense. Before You Start: Please read all of the directions, and familiarize yourself with the collection procedures. The Urine Elements analysis takes 24 hours or less to collect depending on your physician’s instructions. Fish and shellfish contain relatively high levels of mercury and arsenic. It is recommended that you omit fish and shellfish from your diet for one week prior to collecting the urine specimen. You should also refrain from taking non-essential medications or dietary supplements and gadolinium-based contrast media (used in MRI) for 48 hours prior to and during the specimen collection, unless otherwise instructed by your physician. Never discontinue prescription medications without first consulting your physician. Female patients should not collect urine during a menstrual period. Use the provided vial and collection containers to avoid contamination of the specimen. Use of other collection materials may result in falsely elevated results. Verify Kit Contents: 1 Specimen collection cup 1 Specimen vial 1 Zip-lock bag with absorbent material 1 Test requisition form 1 FedEx Clinical Pak with Prepaid Billable Stamp For timed collections less than 24 hrs: 1 clear collapsible 2 liter container For 24 hour collections: 1 orange 4 liter container US & CANADA: 1.800.323.2784 - UK: 0871.218.0052 ELSEWHERE: 1.630.377.8139 - FAX: 1.630.587.7860 3755 Illinois Avenue, St. Charles, IL USA 60174-2420 [email protected] - www.doctorsdata.com 8 If you are missing kit components, please call Doctor’s Data’s Customer Service department for assistance. 8 Save the cardboard collection kit box to ship your samples back to the laboratory. Leave the absorbent material in the zip lock bag. Do not put it in the specimen vial. Follow Collection Instructions A, B, or C as directed: A- If your physician tells you to collect your urine for a time period less than 24 hours in duration. B- if your physician tells you to collect a first morning void (FMV) or random urine sample. C- if your physician tells you to collect a 24-hour urine sample. To open the collapsible container, loosen but don't remove the cap, grasp both ends, and pull open. A1) TIMED URINE COLLECTION (less than 24 hours) Empty your bladder before the collection period begins. Collect all urine up to and including the last urination of the prescribed time period. Collect each urination in the specimen collection cup then pour the urine into the clear collection container. Keep the container in a refrigerator until you are finished with your collection. C1) 24-HOUR URINE COLLECTION When you arise skip your first morning urination. Begin your collection with your second urination and collect all urine up to and including the first morning urination of the following day. Collect each urination in the specimen collection cup then pour the urine into the orange collection container. Keep the orange container in a refrigerator until you are finished with your 24-hour collection. C2) Place the orange collection container on a level surface and read the volume from the markings on the container. In the collection information section of the requisition form (located in the upper right hand corner) fill in the date you finished the collection and your height & weight. Check the box marked 24hours and fill in the total volume collected. C3) Mix the urine by shaking the orange container for at least 30 seconds then pour the urine into the specimen vial. Fill the vial up to the top of the label and then tighten the screw cap securely. Go to step #2. A2) In the collection information section of the requisition form (located in the upper right hand corner) fill in the date you finished the collection, your height & weight, and check the box marked Timed and fill in the number of hours you collected your sample. If the sample was part of a provocation, check either pre or post. 2) Write the patient's name, the date of collection, and patient's date of birth on the specimen vial. The test cannot be performed without the patient information on the vial. Place the vial into the zip-lock bag, then place the bag in the cardboard shipping box. A3) Mix the urine by shaking the clear container for at least 30 seconds then pour the urine into the specimen vial. Do not squeeze the neck of the container or the cap might pop off. Fill the vial up to the top of the label and then tighten the screw cap securely. Go to step #2. 3) Fill out the test requisition form completely and sign it. The test cannot be performed without a properly filled out requisition. Place the completed requisition form in the cardboard shipping box. The specimen is now ready for shipment. B1) FMV/RANDOM COLLECTION Collect a single urination into the specimen collection cup. Pour the urine into the specimen vial. Fill the vial up to the top of the label and then tighten the screw cap securely. To obtain the best results, Doctor’s Data recommends shipping specimens as soon as possible. If you cannot arrange shipping on the same day you finish the collection, such as over a weekend or holiday, refrigerate the specimen until you are ready to ship the test collection kit. B2) In the collection information section of the requisition form (located in the upper right hand corner) fill in the date you finished the collection, your height & weight, and check the box marked Random and fill in the time of day you collected your sample. If the sample was part of a provocation, check either pre or post. Go to step #2. Consult your physician if you have any questions during the test collection process.